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Repetitive Head Impacts Increases the Hazard of Death Among NFL Players – Neurology Advisor

Posted: May 29, 2020 at 5:02 pm

Increasing repetitive headimpacts are associated with an increased hazard of death among professionalfootball players in the National Football League (NFL), a study in the JAMANetwork Open suggests.

The study was aretrospective review of all-cause mortality data from 14,366 football playersduring the 1969 to 2017 NFL seasons. Only data up to July 1, 2018, were includedin this analysis. Pro Football Reference records were used to identify thenumber of seasons and games played by participants. The exposure of interestwas the professional football cumulative head impact index (pfCHII), which wascalculated for 13,912 NFL players. The pfCHII, which quantified the amount andseverity of repetitive head impacts, combined the reported football historywith helmet accelerometer studies in professional players.

A total of 763 of the 14,366players in the initial cohort (5.3%) had died over the follow-up period. Themedian pfCHII among the 13,912 players in the pfCHII analysis was 32.63(interquartile range, 13.71-66.12). The pfCHII scores ranged from 14.18 forwide receivers to 84.34 for offensive linemen. For every 1-log increase inpfCHII, there was a significant increase in the hazard of death for the 1969 to2017 football seasons (hazard ratio [HR], 2.02; 95% CI, 1.21-3.37; P=.01). Additionally, the quadratic pfCHII was significant for the hazard ofdeath during this period (HR, 0.91; 95% CI, 0.85-0.98; P =.01).

Limitations of this study included the variability in measurements of repetitive head impacts across the specified seasons, the inability to adjust for race/ethnicity, and the inclusion of only professional football players vs players who participated in college, high school, or youth football programs.

The investigators of thisstudy suggest that the reduction in repetitive head impacts from playingfootball or other activities through additional rule and equipment changes maybe associated with reduced mortality.

Reference

Kmush BL, Mackowski M, Ehrlich J, Walia B, Owora A, Sanders S. Association of professional football cumulative head impact index scores with all-cause mortality among national football league players. JAMA Netw Open. 2020;3(5):e204442

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Repetitive Head Impacts Increases the Hazard of Death Among NFL Players - Neurology Advisor

Recommendation and review posted by G. Smith